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Open Access Research article

Impact of prostate weight on perioperative outcomes of robot-assisted laparoscopic prostatectomy with a posterior approach to the seminal vesicle

Takahiro Yasui1*, Keiichi Tozawa1, Satoshi Kurokawa1, Atsushi Okada1, Kentaro Mizuno1, Yukihiro Umemoto1, Noriyasu Kawai1, Shoichi Sasaki1, Yutaro Hayashi1, Yoshiyuki Kojima2 and Kenjiro Kohri1

Author Affiliations

1 Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, 467-8601, Nagoya, Japan

2 Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan

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BMC Urology 2014, 14:6  doi:10.1186/1471-2490-14-6

Published: 9 January 2014

Abstract

Background

To determine the effect of prostate weight on the preoperative and postoperative outcomes of robotic-assisted laparoscopic radical prostatectomy with a posterior approach to the seminal vesicle.

Methods

This retrospective study examined prospectively collected data on 219 robotic-assisted laparoscopic radical prostatectomies performed from May 2011 to February 2013. Patients were divided into four groups based on pathologic prostate weight: <30 g, 30–49 g, 50–79 g, and ≥80 g. Continence and sexual function were assessed using validated questionnaires.

Results

Of the 219 patients, 19, 143, 51, and 6 had prostates weighing <30 g, 30–49 g, 50–79 g, and ≥80 g, respectively. Significant differences were found between the preoperative Gleason scores, total operative times, and robotic times of the groups. Both estimated blood loss and anastomosis time tended to be greater in the higher prostate weight groups, but the differences were not significant. No significant differences were observed in transfusion rate, length of catheterization, complication incidence, or positive surgical margins. The return of urinary function, as determined by questionnaire scores, was not affected by prostate weight.

Conclusions

Robotic-assisted laparoscopic radical prostatectomy can be performed safely and with similar perioperative outcomes, regardless of prostate weight. Indeed, oncological outcome, urinary continence, and complications were similar across the prostate weight groups, suggesting that robotic-assisted laparoscopic radical prostatectomy with a posterior approach to the seminal vesicle may be performed effectively on men with large prostates, despite greater surgical times.

Keywords:
Median lobe; Prostate cancer; Radical prostatectomy; Robot-assisted surgery